Healthcare Provider Details

I. General information

NPI: 1962016998
Provider Name (Legal Business Name): AMIT CHOHAN OD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/08/2020
Last Update Date: 05/12/2023
Certification Date: 05/12/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3118 DONNELL DR
FORESTVILLE MD
20747-3203
US

IV. Provider business mailing address

2055 38TH ST SE APT 301
WASHINGTON DC
20020-2442
US

V. Phone/Fax

Practice location:
  • Phone: 301-735-5600
  • Fax:
Mailing address:
  • Phone: 718-679-7288
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number0618002982
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberTA2773
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: